Racial and ethnic differences in patterns of treatment for acute peripheral arterial disease in the United States, 1998-2006

Prior studies have documented racial and ethnic disparities in rates of amputations for peripheral arterial disease (PAD) in the United States. We analyze whether there are underlying differences in the types of treatment provided to patients who are acutely hospitalized for PAD. The 1998-2006 Nationwide Inpatient Sample was used to examine patterns of treatment. We considered a hospitalization an acute admission for PAD if (1) the primary diagnosis was PAD, and (2) the patient was admitted urgently or emergently or through an emergency department. Vascular interventions were designated as open bypass, endovascular intervention, or major amputation, defined as disarticulation at the ankle or higher amputation. From 1998 through 2006, the likelihood of an endovascular procedure being performed during an acute hospitalization for PAD increased from 11.5% to 35.3%, and open vascular procedures decreased from 34.9% to 25.4%. The likelihood of a major amputation during an acute hospitalization for PAD decreased from 29.7% to 20.3%. Black and Hispanic patients were more likely than white patients to undergo amputation and were less likely to have an endovascular or open revascularization. Use of endovascular procedures has increased and use of open vascular bypass has decreased in the inpatient treatment of acute PAD. Although the overall likelihood of amputation has decreased, racial and ethnic differences persist, with black and Hispanic patients experiencing a higher likelihood of amputation.
  • [Show abstract] [Hide abstract] ABSTRACT: A new realisation of adaptive filter is reported which employs a cascade of forward and inverse surface acoustic wave (SAW) analogue Fourier transform processors interconnected via a digital interface. The interface multiplies the transformed input by a set of weights stored in RAM and compares the products against a separately supplied desired complex spectrum. The resulting error is used to update the RAM weights via a feedback loop. The use of frequency domain processing in the adaptive filter offers faster convergence than conventional time domain adaptive transversal filters, and the incorporation of SAW chirp transform techniques extends the adaptive filter to MHz's of signal bandwidth.
    Article · Jan 1983 · Journal of pain and symptom management
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    Conference Paper · Feb 1983 · Journal of pain and symptom management
  • [Show abstract] [Hide abstract] ABSTRACT: Individuals from low socioeconomic (SE) groups have less resources and poorer health outcomes. Understanding the nature of access to appropriate end-of-life care services for this group is important. To evaluate the literature in the developed world for barriers to access for low SE groups. Electronic databases searched in the review included MEDLINE (1996-2010), CINAHL (1996-2010), PsychINFO (2000-2010), Cochrane Library (2010), and EMBASE (1996-2010). Publications were searched for key terms "socioeconomic disadvantage," "socioeconomic," "poverty," "poor" paired with "end-of-life care," "palliative care," "dying," and "terminal Illness." Articles were analyzed using existing descriptions for dimensions of access to health services, which include availability, affordability, acceptability, and geographical access. A total of 67 articles were identified for the literature review. Literature describing end-of-life care and low SE status was limited. Findings from the review were summarized under the headings for dimensions of access. Low SE groups experience barriers to access in palliative care services. Identification and evaluation of interventions aimed at reducing this disparity is required.
    Article · Mar 2011
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